Abstract
Aims
Metabolic syndrome (MetS) is a cluster of risk factors for cardiometabolic diseases. While cigarette smoking is associated with MetS in adults, young adulthood is an under-studied, susceptible period for developing long-term morbidity from MetS. We examined associations between cigarette smoking and MetS risk factors.
Methods
We studied 430 participants in Santiago, Chile who have been followed in a longitudinal cohort since infancy and assessed in adolescence for MetS. Participants were evaluated at 22 years from May 2015 to July 2017. Adiposity, blood pressure, and blood samples were measured. MetS was defined using International Diabetes Federation criteria. A continuous MetS score was calculated using z-scores. Participants self-reported cigarette and alcohol consumption using standardized questionnaires. We used multivariate regressions to examine associations between smoking and MetS risk factors, adjusting for sex, MetS in adolescence, alcohol consumption, and socioeconomic status.
Results
Thirteen percent of participants had MetS and 50% were current smokers. Among smokers, mean age of initiation was 14.9 years and consumption was 29 cigarettes weekly. Smokers had larger waist circumferences, higher BMIs, and lower high-density lipoprotein (HDL) cholesterol compared to non-smokers. Being a current smoker was significantly associated with higher waist circumference (β = 2.82; 95% CI 0.63, 5.02), lower HDL (β = − 3.62; 95% CI − 6.19, − 1.04), higher BMI (β = 1.22; 95% CI 0.16, 2.28), and higher MetS score (β = 0.13, 95% CI 0.02, 0.24).
Conclusions
Cigarette smoking at light levels (mean < 30 cigarettes weekly) was associated with MetS risk factors in a sample of Chilean young adults.
Similar content being viewed by others
References
Misra A, Khurana L (2008) Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab 93:S9–S30. https://doi.org/10.1210/jc.2008-1595
Yach D, Stuckler D, Brownell KD (2006) Epidemiologic and economic consequences of the global epidemics of obesity and diabetes. Nat Med 12:62–67
Alberti KGMM, Eckel RH, Grundy SM et al (2009) Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International. Circulation 120:1640–1645. https://doi.org/10.1161/circulationaha.109.192644
Isomaa B, Almgren P, Tuomi T et al (2001) Cardiovascular Morbidity and Mortality. Diabetes Care 24:683–689
Lorenzo C, Williams K, Hunt KJ, Haffner SM (2007) The National Cholesterol Education Program-Adult Treatment Panel III, International Diabetes Federation, and World Health Organization Definitions of the Metabolic Syndrome as Predictors of Incident Cardiovascular Disease and Diabetes. Diabetes Care 30:8–13. https://doi.org/10.2337/dc06-1414
Wilson PWF, Agostino RBD, Parise H et al (2005) Metabolic syndrome as a precursor of cardiovascular disease and type 2 diabetes mellitus. Circulation 112:3066–3073. https://doi.org/10.1161/CIRCULATIONAHA.105.539528
Sun K, Liu J, Ning G (2012) Active smoking and risk of metabolic syndrome: a meta-analysis of prospective studies. PLoS One 7:e47791. https://doi.org/10.1371/journal.pone.0047791
Zhang L, Guo Z, Wu M et al (2013) Interaction of smoking and metabolic syndrome on cardiovascular risk in a Chinese cohort. Int J Cardiol 167:250–253. https://doi.org/10.1016/j.ijcard.2011.12.079
Nakanishi N, Takatorige T, Suzuki K (2005) Cigarette smoking and the risk of the metabolic syndrome in middle-aged Japanese male office workers. Ind Health 43:295–301. https://doi.org/10.2486/indhealth.43.295
Keith RJ, Al Rifai M, Carruba C et al (2016) Tobacco use, insulin resistance, and risk of type 2 diabetes: results from the multi-ethnic study of atherosclerosis. PLoS One 11:e0157592. https://doi.org/10.1371/journal.pone.0157592
Fujiyoshi A, Miura K, Kadowaki S et al (2016) Lifetime cigarette smoking is associated with abdominal obesity in a community-based sample of Japanese men: the Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA). Prev Med reports 4:225–232. https://doi.org/10.1016/j.pmedr.2016.06.013
Slagter SN, van Vliet-Ostaptchouk JV, Vonk JM et al (2013) Associations between smoking, components of metabolic syndrome and lipoprotein particle size. BMC Med 11:195. https://doi.org/10.1186/1741-7015-11-195
Will JC, Mokdad A, Will JC et al (2001) Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study. Int J Epidemiol 30:540–546. https://doi.org/10.1093/ije/30.3.540
Ferreira I, Twisk JWR, van Mechelen W et al (2005) Development of fatness, fitness, and lifestyle from adolescence to the age of 36 years: determinants of the metabolic syndrome in young adults. Arch Intern Med 165:42–48
Attard SM, Herring AH, Howard AG, Gordon-Larsen P (2013) Longitudinal trajectories of BMI and cardiovascular disease risk: the national longitudinal study of adolescent health. Obesity 21:2180–2188. https://doi.org/10.1002/oby.20569
Kandel DB, Logan JA (1984) Patterns of drug use from adolescence to young adulthood: I. Periods of risk for initiation, continued use, and discontinuation. Am J Public Health 74:660–666. https://doi.org/10.2105/AJPH.74.7.660
Sun K, Ren M, Liu D et al (2014) Alcohol consumption and risk of metabolic syndrome: a meta-analysis of prospective studies. Clin Nutr 33:596–602. https://doi.org/10.1016/j.clnu.2013.10.003
Lozoff B, Andraca I, De Castillo M et al (2003) Behavioral and developmental effects of preventing iron-deficiency anemia in healthy full-term infants. Pediatrics 112:846–854
Roncagliolo M, Garrido M, Walter T et al (1998) Evidence of altered central nervous system development in infants with iron deficiency anemia at 6 mo: delayed maturation of auditory brainstem responses. Am J Clin Nutr 68:683–690
Burrows R, Correa-Burrows P, Reyes M et al (2016) High cardiometabolic risk in healthy Chilean adolescents: associations with anthropometric, biological and lifestyle factors. Public Health Nutr 19:486–493. https://doi.org/10.1017/S1368980015001585
Graffar M (1956) Une méthode de classification sociale d’échantillons de population. Courrier 6:455–459
World Health Organization (2019) BMI classification. In: Global database body mass index. http://apps.who.int/bmi/index.jsp?introPage=intro_3.html
Roberts C, Freeman J, Samdal O et al (2009) The Health Behaviour in School-aged Children (HBSC) study: methodological developments and current tensions. Int J Public Health 54:140–150. https://doi.org/10.1007/s00038-009-5405-9
Brage S, Wedderkopp N, Ekelund U et al (2004) Features of the metabolic syndrome are associated with objectively measured physical activity and fitness in danish children. Diabetes Care 27:2141–2148
Moore JX, Chaudhary N, Akinyemiju T (2017) Metabolic syndrome prevalence by race/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988–2012. Prev Chronic Dis 14:160287. https://doi.org/10.5888/pcd14.160287
Ragland D (1992) Dichotomizing continuous outcome variables: dependence of the magnitude of association and statistical power on the cutpoint. Epidemiology 3:434–440
Naggara O, Raymond J, Guilbert F et al (2011) Analysis by categorizing or dichotomizing continuous variables is inadvisable: an example from the natural history of unruptured aneurysms. Am J Neuroradiol 32:437–440. https://doi.org/10.3174/ajnr.A2425
Altman DG (2006) The cost of dichotomising continuous variables. BMJ 332:1080–1080. https://doi.org/10.1136/bmj.332.7549.1080
Departamento de Epidemiología del Ministerio de Salud de Chile (2017) Encuesta Nacional de Salud 2016-2017: Primeros resultados. http://epi.minsal.cl/resultados-encuestas/
Clair C, Chiolero A, Faeh D et al (2011) Dose-dependent positive association between cigarette smoking, abdominal obesity and body fat: cross-sectional data from a population-based survey. BMC Public Health. https://doi.org/10.1186/1471-2458-11-23
Cena H, Tesone A, Niniano R et al (2013) Prevalence rate of metabolic syndrome in a group of light and heavy smokers. Diabetol Metab Syndr 5:28. https://doi.org/10.1186/1758-5996-5-28
Walldius G, Jungner I (2004) Apolipoprotein B and apolipoprotein A-I: risk indicators of coronary heart disease and targets for lipid-modifying therapy. J Intern Med 255:188–205
Arsenault BJ, Lemieux I, Després JP et al (2009) HDL particle size and the risk of coronary heart disease in apparently healthy men and women: the EPIC-Norfolk prospective population study. Atherosclerosis 206:276–281. https://doi.org/10.1016/j.atherosclerosis.2009.01.044
Facchini F, Hollenbeck C, Jeppesen J et al (1992) Insulin resistance and cigarette smoking. Lancet 339:1128–1130
Cryer P, Haymond M, Santiago J, Shah S (1976) Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events. N Engl J Med 295:573–577
Miranda JJ, Herrera VM, Chirinos JA et al (2013) Major cardiovascular risk factors in Latin America: a comparison with the United States. The Latin American Consortium of Studies in Obesity (LASO). PLoS One 8:1–10. https://doi.org/10.1371/journal.pone.0054056
Vio F, Albala C, Kain J (2008) Nutrition transition in Chile revisited: mid-term evaluation of obesity goals for the period 2000–2010. Public Health Nutr 11:405–412. https://doi.org/10.1017/S136898000700050X
Acknowledgements
This project was supported by grants by the National Institutes of Health, Heart, Lung, and Blood Institute [HL088530, PI: Gahagan]. Evaline Cheng was also funded by the Global Health Institute and Global Health Academic Concentration at the University of California, San Diego School of Medicine. Dr. Correa was supported by the Advanced Human Capital Program, National Commission of Scientific and Technological Research (Santiago, Chile). The authors thank the study participants and their families for their continuous involvement.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical approval
All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Additional information
Managed by Massimo Federici.
Rights and permissions
About this article
Cite this article
Cheng, E., Burrows, R., Correa, P. et al. Light smoking is associated with metabolic syndrome risk factors in Chilean young adults. Acta Diabetol 56, 473–479 (2019). https://doi.org/10.1007/s00592-018-1264-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00592-018-1264-2